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Fernando Felix — ADJ12202655

FERNANDO FELIX, Applicant vs. DPR CONSTRUCTION, INC. and NATIONAL FIRE INSURANCE COMPANY OF PITTSBURGH, PENNSYLVANIA, administered by AMERICAN INTERNATIONAL GROUP, INC., Defendants

ADJ number: ADJ12202655
Decision date: Apr 4, 2021
District office: Long Beach
WCJ: —
Claim administrator: American International Group, Inc. (administering for National Fire Insurance Company of Pittsburgh, Pennsylvania)
Commissioners: DEIDRA E. LOWE, COMMISSIONER, ANNE SCHMITZ, DEPUTY COMMISSIONER, MARGUERITE SWEENEY, COMMISSIONER

Injury / body parts: bilateral knees

LC §5903LC §5952LC §5701LC §5906

Summary

Applicant Fernando Felix, a drywall taping superintendent, claimed cumulative trauma injury to both knees during employment with DPR Construction from May 18, 2017 through May 18, 2018. The WCJ found no AOE/COE injury, relying on the QME report of Dr. Hwang while rejecting the PTP report of Dr. Secor. On reconsideration, the Board found that neither Dr. Secor's nor Dr. Hwang's reports constituted substantial evidence because both inaccurately described applicant's job duties and failed to provide adequate reasoning. The Board granted reconsideration, rescinded the F&O, and remanded for further development of the record, suggesting evaluation by an AME or appointment of a regular physician.

Issues

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Holding

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Analysis

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Applicant takeaway

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Defense takeaway

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Provider takeaway

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Similar decisions

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Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.